Provider Demographics
NPI:1629324074
Name:CHEUNG, MATTHEW MAN-YIU (OD)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MAN-YIU
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343B S WENTWORTH AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2013
Mailing Address - Country:US
Mailing Address - Phone:312-225-5829
Mailing Address - Fax:
Practice Address - Street 1:2343B S WENTWORTH AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2013
Practice Address - Country:US
Practice Address - Phone:312-225-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist